Celiac disease demands gluten-free diet

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— March is National Nutrition Month. This year's slogan, "Healthy Eating, Healthy You," can be a challenging goal for people suffering from celiac disease.

Once thought to be rare in the United States, celiac disease or celiac sprue may affect as many as one out of 133 people.

The onset of this inherited autoimmune disorder can occur at any age and it is genetically linked to type 1 diabetes.

Symptoms of celiac sometimes appear after severe emotional stress, pregnancy, surgery or a virus.

People with celiac disease cannot tolerate the protein gluten, which is found in the grains wheat, rye, barley and oats. When gluten is ingested an immune reaction damages fingerlike structures called villi in the intestine. When villi are damaged, nutrients are not well absorbed.

Symptoms of celiac disease vary but can include diarrhea, constipation, osteoporosis and anemia. People with celiac often complain of fatigue, weight loss, sinus infections, painful joints and other allergies.

There is no cure for this disease and there are no medications to treat it. The disease is treated by strict adherence to a gluten-free diet for life.

Sounds easy, but gluten is hidden in many foods such as beer, soy sauce, ricotta cheese and salad dressings. So going out for a pizza and a beer is not part of your lifestyle if you suffer from celiac.

In fact, dining out at restaurants can be quite a challenge. Not only do foods need to be gluten-free, but reactions can occur if there is cross-contamination with gluten.

This can occur, for example, if the same butter knife used on wheat bread is then used on gluten-free bread.

Celiac disease is diagnosed by a blood test that screens for antibodies found in most people with celiac disease. The disease is confirmed by a biopsy of the intestine.

When people are first diagnosed, they tend to feel overwhelmed by all the foods they must avoid.

For those struggling with their diets, I recommend clients focus on what they can have instead of all the forbidden foods. More meal planning and close attention to food ingredients is a must. A registered dietitian can help you choose the right foods to avoid gluten.

At Yampa Valley Medical Center, the celiac discussion group meets every couple of months. This group is especially helpful for those newly diagnosed with celiac. Some participants do not have celiac themselves but want to know what to feed visiting relatives who have the disease.

People who have had celiac for many years and those who are newly diagnosed discuss life experiences, frustrations and how to better manage the disease.

Recipes, cookbooks, and gluten-free food manufactures are reviewed.

Participants recommend local restaurants and chefs that are able to accommodate their special dietary needs.

Fortunately, local, regional and national resources are plentiful.

The Celiac Sprue Association provides current information and educational materials (often free) at www.csacelacs.org or (402) 558-0600.

There are chapters of the Celiac Association in Denver, northern Colorado and Colorado Springs. Safeway's list of gluten-free food products can be requested by calling (888) 723-3929 or by visiting www.safeway.com.

The American Dietetic Association has eating tips at www.eatright.org.

At Healthy Solutions health food store in Steamboat Springs, gluten-free foods are marked with green stickers. Bamboo health food store in Steamboat has a list of gluten-free foods.

Bud Werner Memorial Library carries several gluten-free cookbooks. Yampa Valley Medical center's Community Health Resource Center has a variety of resources and cookbooks on celiac sprue.

Carol Mahoney, M.S., R.D., is Registered Dietitian at Yampa Valley Medical Center.

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